In Reply to: Case 0498_07 -- Giant pericatheter thrombus complicated by massive pulmonary embolism posted by Editor on March 31, 1998 at 14:51:15:
Interesting case. In answer to your questions:
1) yes, under the clinical circumstances this
was an excellent use of spiral CT and there was
no need for diagnostic pulmonary angiography....
HOWEVER.......
2) I think the appropriate course of action was
chosen. But, I want to hear from those IR's out there who would have followed diagnostic angio
with urokinase +/- use of a mechanical thrombectomy device....
3) Although this may represent a case of massive
pulmonary embolus secondary to "Open-cath," I will
continue to recommend its liberal use for previously functioning central catheters. I feel
that significant pulmonary embolus is an extremely rare event. Furthermore, one would have to recommend a cathetergram, echo, or CT prior to any form of therapy for a dysfunctional central line.